Showing posts with label bone pain. Show all posts

Let's see if I can do this without tangling myself into words and give readers a migraine. But there is a point in my fracture healing process where I no longer recognize pain as a sensation, but as a thing.

Still with me? Maybe some of you are nodding in agreement and know what I am talking about? No? Let me continue.

I don't know when I first differentiated between pain as a thing vs. pain as a sensation but one day it just happened. Since then I have come to recognize that when the pain makes this switch, things are getting better. It has become something of a benchmark to me where I now realize: Soon that throbbing will fade away completely. Soon the nights of muscle cramps will stop. Soon all I'll have to worry about are people accidentally bumping into me, and for how long I can keep my mind off the itching.

When a fracture first happens I feel everything about it. I feel where the bone has broken, when it is jostled, when my breathing has moved it even a millimeter, when there is even a slight dip in the pavement or mattress. I feel it outside and beyond the sharp burning sensation that comes with a fresh fracture. It is in the hesitating way that I breathe, the way I am sweating a waterfall of bullets, the way I have lost all focus on everything else in the world except for that crack in my bone that should not be there. Those are the sensations that let me know I am in pain. Because suddenly when it is time to be positioned on the x-ray table I have stopped breathing, because I think if I do not fill my lungs with oxygen maybe those air bubbles will not carry the sensation of pain to my brain. I am always wrong. I know I'm in pain because during those five seconds the radiologist has ducked behind his little window, I relish in the moment of temporary stillness. In my mind I am pushing those waves of ebbing pain out of my head so that I might make room to experience the sensation of calm. My body suddenly turns cold as the sweat evaporates, but then it rains down on me again when he pops out from behind his window and says, "okay so for the next picture I need to move..." Pain is when I clench my jaws so tight I think I may have broken it as my doctor wraps the cotton layers around my leg, I wince as his fingers bring the roll of padding around the injured area. I tell myself it is all for the greater good so suck it up. Those are the moments I experience pain as a sensation.

Pain as an object is something I recognize in my head. It is easy to put away into a box, package it and put it on the back burner of my mind - and hope that I may turn the stove on so hot it will just burn it all and have it disintegrate to ashes. It is more than just a pesky dull ache because someone has accidentally bumped into my leg in a cast. But it is also less than the nagging tug and shimmy of muscle spasms at 2, 3, and then 4 in the morning. Pain as an object is something that just exists like a blemish on a banana, I recognize it but shrug my shoulders because there are bigger annoyances to my day that I can at least do something about. As a thing, pain is neither obnoxious or pretentious; it doesn't really demand all the attention in the room and nor does it expect to be the darling recipient at the pity party. This is the kind of pain visitor that has so abused its stay that it has left a numbing imprint on its surroundings. No one bats an eye or so much as waves as it comes and goes. I expect its presence, but I don't say that in any kind of heroic way or in an attempt to be brave, and definitely not inspirational. I say that in the kind of way that I am telling you that I expect the grass to still be green underneath all this snow. Pain as an object is something that I don't need to go chasing around my body, I don't need to lasso it all into a single number on a scale of 1 - 10 after surgeries. Pain as an object fits in my hands like it was made for these palms, and I can manipulate it like origami from frog to koi fish.

So there they are, the two different kinds of pains in my fracture healing process. These are the things I tell myself to pass the days or weeks, they are things I scrutinize just as closely (albeit privately) as my doctor honing in on the x-rays.

In a couple of weeks I will be another year older. I will have gone around the sun once more, and I appreciate you all for joining me in this galactic adventure! But there are some things that come with age that I am not so thrilled about, some happenings that I am taking more note of and a little freaked out by. Today I will talk about one of those getting-old-er-things:

Bone pain.

Since O.I. has much to do with the skeletal structure and there are many types of 'bone pains' associated with having O.I. - let me attempt to describe the bone aches that I am talking about.

I imagine it as the start of a dull migraine, but inside a bone as opposed to your noggin. This is the kind of bone ache that is not associated with post-operation roddings, and it is not as urgent as the bone ache associated with a fracture. This is the kind of bone ache that is like a row of perfectly hung family photos, and then there is that one that seems a little tilted to one side or the other. It is annoying, because no matter which way I might shift or move myself - I am rarely able to right things again. It is that knot in your headphones that no one ever knows how it got there; this bone pain is when you finally untangle that knot and that part of the wires lay disgruntled from a rude awakening. Other times it is like an itch that can only be scratched when you crack your knuckles, or when you wiggle your knee in that weird way that feels like it's jumping in and out of the socket. It appears cold, or suddenly hot to the touch, it can pinch, or just hang around dragging its feet along the length of our femurs till it finally shuffles off somewhere in our hips.

These bone aches are usually not detectable by x-ray or MRI, but just because they can't see it doesn't mean we can't feel it - can't know its shape and size, and exactly how to get rid of it if only we could get our fingers *in* there!

The toughest part, for me, when I have bone aches is not letting it get to my mood. The last thing I would want is to be that 20-something who gripes about the ache in my joints, or how the "rains make my wrists hurt.." It is difficult to have the patience for others, or to carry myself in an upbeat manner when I would rather float on a waterbed towards my own private island. Still, in a weird way, learning to manage the bone pain by not letting it get to me is very much a part of how I manage the pain! Distracting myself with work, or forcing myself to be even more present in the moment, and reminding myself that even with the inexplicable aches - I must choose to participate and be engaged in the everyday, because otherwise I would be more annoyed with myself, even more grumpy.

It has yet to get to the point where I resort to popping an ibuprofen and going about my day. It might also be because I do not associate *these* kinds of bone aches with the need to take medication, (I associate pain medications with post-op pains)..the point being, these are all moments that will pass. But when it does pass, will I be able to say "I took part in its passing" or will I be able to say "I watched it pass me by"?
These are not easy decisions to make, despite how frequently it may look like we make these choices. I can only hope that as I get older, there will be more instances where I can make these choices because I am the first to say that I could really use more practice.

No position you turn or lay on seems to make a difference. And the awkward angle at which your legs are parted in that spica cast is just.. awkward and uncomfortable. There is an itch deep down in your cast that you can't get to no matter how you bend the coat hanger; and for the millionth time NO, ANOTHER PILLOW WON'T HELP! JUST. GO. AWAY!

I am sure all of us have experienced a discomfort that was indescribable. We then begin to tunnel ourselves further into a hole because we think: no one else understands, no one else has felt this, no one else knows how to make it stop, no one wants to be around this kind of pain, no one no one no one..Until all of a sudden we are sitting by ourselves in bed, grumpy and at a loss for what to do.

This is the part where I am afraid to make another confession. But here goes: Sometimes being by myself with the pain helps me feel better. A lot better. No it's not because I am anti-social and a miserable person, I promise!

I could easily attribute this to my stubborn personality. When things get tough I have a tendency to just curl inwards and deal with problems on my own. The more other people nit-pick, nag, remind, or suggest things for me in times of high stress and pain -- the quicker I am to lash out and intentionally isolate myself. This isn't a good thing necessarily, but it is the way that I cope. It's how I manage and it's how I get back to making myself feel better.
Over the years I have tried to become more mindful of that behavior. When things are beginning to make me "hermit-ize" I take a moment to ask myself: Is this a step to making me feel better? Or am I isolating myself because I just don't want to deal with anyone else?

If it's the first reason then fine. I let people know that "It'll make me feel better to be by myself for a little while.." or I say "I'd like to get some rest alone please.." If it's the second reason I try to accept that feeling negative in times of stress and pain are natural. I tell myself there is nothing wrong with me because I want to burrow inside a hole of blankets and sheets (and possibly never come out). I then try to remind myself that this other person is most likely trying to help, and while s/he might not understand what I'm going through - I should acknowledge and appreciate their efforts in getting me through a tough time. I then assure them that thanks to their help I will be okay by myself for a bit. It's not easy to calmly think through your pain when you're in the moment, but even taking that first step of realizing your feelings when you're in that state of being will do wonders.

I suppose the point of this blog entry is to realize that everyone has their own way of coping. No way is right or wrong, but it is important that we realize everyone responds differently. For one person putting five pillows underneath a full leg cast feels like they are on top of cloud 999; for someone else it might feel like the most traumatizing sensation ever!
At the end of the day we can only be us. We can only do whatever will make us feel better, we can only hope that what we do now will make the next minutes easier for all of us.

For a few seconds I believe the bed has swallowed my entire body, leaving only my eyeballs. At first I can feel nothing else, and my brain seems to still be wiping the dredges of the anesthesia off - for the time being it can only send a few bursts of signals to my eyes. All I see are the glaringly obnoxious fluorescent lights above, then the curtain divider, and then from the corner of my eyes the machines with all of its wires that are all heading in my direction.
Meanwhile the room has begun a slow counterclockwise tumble: the ceiling melts into the wall, the fluorescent lights look like they're about to fall on to me and then there it is -- the tips of my fingers brush past the top of the cast. The familiar dimpled ridge texture of the fiberglass cast sends my brain shooting down memory lane, and then it all comes back to me: a rod surgery on my left tibia.

I yak up stomach bile as I always do after operations. It's the final signal that says: okay your body is awake now. The nurse holds out a small cup of water for me as I hungrily gulp it down, like it's some kind of mirage that might disappear on me any second.
It's sometime between when I first remember what has happened and the time I am given my first sips of water that the pain hits.
"It was a long surgery, Sandy. Far longer than anyone expected. It lasted 6 hours and Dr. Shapiro had to make 4 breaks into the bones." The nurse tells me.
Still not really able to form complete thoughts yet, I make a sound that is something between a groan and a cry. My hands grasp at the fiberglass cast, fingers scratching at a leg that only that morning I had been able to touch the skin of. Now it lay in several pieces, with all kinds of hardware screwed into the bone - that thought alone made me squirm.
"Don't be afraid to push the pain button, okay?" She put a small buzzer into my right hand, the one that wasn't already swamped with I.V.'s swarming about. I nodded my head, half rolling my eyes to tell her that I already know all too well what the pain button does.

After my vitals are checked again, and a room upstairs has opened up I am rolled to the 9th floor in a room that is across from the nurse's station. It's the room I am always in after rod surgeries, a single room to myself with the border of animal decorations going around the walls. The first night after surgery is always the worst for me. The throb of pain ebbs and flows all throughout the night, the morphine makes me frantically itchy, and my dreams are a mix of lucid reality with the backdrop of pain medication. In short: I have no idea what is going on.
Several times an hour various nurses will come and check on my vitals. But the blood pressure stands that give my arm a gentle hug at midnight, then 1AM, 2AM, 3AM.. has appeared to me as various morphed alien-octopus creatures with tentacles that squeeze for a bit then get ripped off.

In the dim of the night light, and mixed with the neon glow of the machines I could tell he was wearing a large blue cookie monster t-shirt. Must be one of the perks of working at Children's Hospital I thought. Rarely do I remember anything about my stays as an inpatient, especially during the first night after an operation - but for whatever reason the guy checking my vitals that night made an impression. He was going about his business, jotting down my numbers and adjusting my oxygen mask when all of a sudden I blurted out:
"Wouldn't you rather be somewhere else?" 
He stopped what he was doing and looked down at me, smiling,
"No of course not! If I were anywhere else I wouldn't be able to help you and there's nothing else I would rather be doing." 


To this day I have no idea what spurred on my question. I don't remember what my thoughts were before I asked it, but it's pretty obvious that I wanted to be somewhere far away from the 9th floor of the Children's Hospital in-patient floor. But his response comforted me the rest of that night, I remember I slept as comfortably as I could knowing that despite my drugged and broken state of being - there was someone in the world who wanted to be there to help hold me together.

Many readers already know that having a fracture isn't the only source of bone pain. I know that I'm very fortunate to not experience chronic bone pain, so for this entry I thought I'd do my best to describe the various kinds of aches & burns that I have difficulty explaining to my un-affected family, doctors, or friends... so, in other words.. I've never actually told anyone about this.


1. The Dull Ache That Spreads. It might start in my elbow or in my knee, an ache that just pops its head in the neighborhood because it was bored. After it settles in for a bit it'll take a little jaunt down the length of my arm or up my shoulder, or maybe it'll troop up my femur to check out the scene. Sometimes I wish I could just tell it to get lost or say something like, "nope, nothing's changed. Still 3ft tall and stillll not walking. Thanks for swinging by though, tell your mom I say hi!" This next bit is going to sound weird but if it happens in my arm, if I crack my knuckles it'll feel better. Or sometimes if I change sitting positions it'll fade a bit, I imagine when I do that the pain gets all discombobulated as I jostle it around - giving it a whirl before it regains its original pain in the ass mission again.

2. The Burn At The Peak. This happened nightly during the months and weeks when my tibias were at their worse. When I was younger both of my tibia bones was at near right angle degrees, it looked like I had two knees before they were finally rodded (several times). On the x-rays there was no visible fracture but my doctor would tell me that there are probably several tiny microscopic fractures at the peak of the tibia bone, and every night for awhile it would burn. Several times I would wake up and throw the covers off, touching the top of my shin making sure that the skin hadn't just burned off. I wanted to ask what the microscopic fractures were doing on top of that peak, having some kind of bonfire party before the big operation? Once I'd finally found a comfortable position to sleep in of course the burning would happen the next night, and then I'd try to sleep again in that position but it would never work. I had to cycle through various sleeping positions, constantly trying to find the next coldest spot in my bed for my leg.

3. The Ache Inside The Cast. You would think that once inside the cast the sharp pain and aches just stop. But somehow that isn't always true. Sometimes no amount of fiber glass and cotton can subdue the ache, and these can sometimes be the worst. And most of the time the aches aren't even in the same area where the fracture was! At first I'll think that it's just a muscle spasm, but then I realize it hasn't got that same edge; however, since there is only about 500 layers of cotton and fiber glass separating me from the ache I can't exactly go check on it like I usually do. Instead I'm resorting to wiggling inside the cast, and when I say wiggling I mean moving microscopic millimeters so as not to disturb the actual pain of the fracture. I might as well be trying to walk through a cave of sleeping lions!

4. The Sharp Ache That's Not Sharp Enough. It isn't the same sharp breath-stealing, heart-pumping, sweat-pouring pain that a fracture brings on, instead it's just a few steps below it. It's like the long lost cousin of the actual fracture that shows up at a family reunion, and no one knows how to react to him. He's kinda awkward - doesn't exactly have the best manners, has a shady history, and a weird mole on his eyelid. But he's there at the family reunion and absolutely insists on being in every single picture. Most of the time, this is the ache that happens in the same area where I will have my next fracture; it's like the foreshadowing of the hot mess events to come. Usually I just quietly stow it away in my head, smiling into the camera anyway and trying my best to keep this weird long lost cousin at arms length away.